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Table of Contents
CASE REPORT
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 20-22

Clinical applications of diode laser in oral and maxillofacial surgery: A case series


1 Shri G.D. Birla Trust Memorial Hospital, Ujjain, Madhya Pradesh, India
2 Private Practitioner, New Delhi, India
3 Private Practitioner, Gadarwara, Madhya Pradesh, India
4 Private Practitioner, Deoghar, Jharkhand, India

Date of Submission21-Feb-2022
Date of Acceptance03-Mar-2022
Date of Web Publication25-Mar-2022

Correspondence Address:
Dr. Anchal Mudgal
Shri G.D. Birla Trust Memorial Hospital, Ujjain, Madhya Pradesh.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_4_22

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  Abstract 

Soft tissue diode lasers are becoming popular among clinicians due to their potential value in surgical procedures providing, surface sterilization, dry surgical field, and increased patient acceptance. Twenty-five patients with different soft tissue lesions were selected, and soft tissue diode laser was used for excision and wound healing was assessed by the visual method with photographs. No discomfort to the patient during and after the laser procedure was observed. In spite of using minimal local anesthesia, avoiding placement of sutures, and not prescribing any antibiotics, minimal bleeding, no edema, and good wound healing were observed. We conclude that laser treatments can be superior to conventional approaches with regard to easy ablation, decontamination, and hemostasis and are less painful during and after the procedure.

Keywords: Diode laser, mucocele, oral and maxillofacial surgery, intraoral lipoma, peripheral ossifying fibroma


How to cite this article:
Mudgal A, Jha AC, Patel VS, Kumar A. Clinical applications of diode laser in oral and maxillofacial surgery: A case series. Int J Oral Care Res 2022;10:20-2

How to cite this URL:
Mudgal A, Jha AC, Patel VS, Kumar A. Clinical applications of diode laser in oral and maxillofacial surgery: A case series. Int J Oral Care Res [serial online] 2022 [cited 2022 May 25];10:20-2. Available from: https://www.ijocr.org/text.asp?2022/10/1/20/340918




  Introduction Top


Lasers have been used in oral and maxillofacial surgery for decades. The first documented use of lasers in oral and maxillofacial surgery was published in 1977.[1],[2] The reason for this transition is due to the fact that many procedures can be executed more efficiently and with less morbidity using lasers when compared with a scalpel, electrocautery, or high frequency devices. Early lasers were bulky and historically used for major cases in operating theaters; but today, access to small, portable, office-based lasers with improved intraoral delivery systems have made it possible to treat even minor routine procedures in the clinic.[3],[4],[5],[6],[7],[8],[9],[10],[11],[12] The aim of this case report was to present the clinical effects of diode laser irradiation on oral soft tissues during oral surgery and to demonstrate wound-healing characteristics after laser surgery.


  Case Report Top


Twenty-five patients with different oral surgical indications are included in this report. All of the patients were indicated for oral surgical procedure with the diode laser. The maximum output power was up to 15 W yet operated up to 9 W and had a continuous as well as a pulsed mode. Soft tissue surgery was carried out with different power settings, continuous or pulsed mode, and the use of a contact (focussed) or non-contact (defocussed) hand piece. The surgical procedures were performed under topical or local anesthesia [Table 1]. All of the clinical cases were examined in the first 3 days, 1 week, 2 weeks, and 3–4 weeks after surgery. Post-operative complications such as pain, bleeding, swelling, sensory disturbances, and functional and/or mobility disorders, as well as wound-healing characteristics, were evaluated. Only two cases experienced mild hot feeling sensation, and swelling was absent in all cases except one patient who underwent vestibuloplasty and even developed mild paresthesia but that recovered within 2 months of surgery. All other cases healed uneventfully with minimal requirements of analgesics (predominantly with potent anti-inflammatory action than analgesics like ibuprofen 200–400 mg), while antibiotic dependency was also markedly reduced (except in the tongue right lateral border incisional biopsy case which later confirmed to be a neoplasm) because of the local sterile environment. Laser bandages of the surgical sites were attained in all the cases. The same is clearly visible in the pre-, intra-, immediate, and delayed post-operative pictures of the patients which are as follows [Figure 1] and [Figure 2].
Table 1: Maxillo-facial surgical procedure performed with the diode laser wavelengths (805– 980 nm)

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Figure 1: Fibroma corresponding to the level of occlusal plain created by a complete denture on the left side of the mouth, which is traumatic in nature

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Figure 2: Incisional Biopsy of the tongue

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  Discussion Top


One of the applications of lasers in dentistry is soft tissue surgery and ablation of lesions. The excision of exophytic lesions is one of these applications. The advantages of laser application are relatively bloodless surgery, minimal swelling, scarring and coagulation, no need for suturing, reduction in surgical time, and less or no post-surgical pain. Furthermore, the laser instantly disinfects the surgical wound and there is no mechanical trauma to the tissue.[1],[2],[3],[4] The unique specialties of diode lasers, such as sharp and definite cutting edge, hemostasis, and coagulation after surgery in addition to small size and better maneuverability during application, make them very effective and a useful alternative device in soft tissue surgery in the oral cavity in comparison to other laser types such as carbon dioxide laser (CO2) and erbium lasers. In all the cases, a definitive excision of the lesion was accomplished and good healing was observed. During the procedure, the patients did not experience any discomfort or pain and no post-operative pain was observed. Minimal bleeding during the procedure was observed. Minimal local or topical anesthesia was needed during the procedure, and there was no need for suturing the surgical wound. Post-operatively, there was no edema and good healing was observed after 1 month of the procedure. Laser-induced wounds because of a definite and clean wound generally heal with secondary intention and no scar formation. This is may be due to the minimal degree of wound contraction following laser irradiation, which occurs through induction and formation of a smaller number of myofibroblasts and collagen. All parameters of lasers are selected based on thorough knowledge of laser applications in medical and dentistry involving basis principles of laser physics, laser chemistry, and laser–tissue interactions, such as selection of wavelength power irradiance must be based on the presence of substrate specific chromophores. Also one should keep in mind always that intra-operative conditions give equal emphasis on post-operative healing events, which can easily be attained by carefully performing selective photothermolysis, where ever intended.[5],[6],[7],[8],[9],[10],[11],[12] All of these will ultimately result in faster, uneventful, and least medication-dependent wound healing with predictable final outcome, when compared with conventional-primitive scalpel or electrocautery or RF systems, which falsely proclaimed similar results at the same time and comfort.


  Conclusion Top


The application of diode lasers has been recognized as an adjunctive or alternative approach in soft tissue surgeries. Laser treatments have been shown to be superior to conventional mechanical approaches with regard to easy ablation, decontamination, and hemostasis, as well as less surgical and post-operative pain in soft tissue lesion management.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Romanos G, Nentwig GH. Diode laser (980 nm) in oral and maxillofacial surgical procedures: Clinical observations based on clinical applications. J Clin Laser Med Surg 1999;17:193-7.  Back to cited text no. 1
    
2.
Asiiinoff R, Geronemus RG. Capillary hemangiomas and treatment with the flash-lamp pumped pulsed dye laser. Arch Dermatol 1991;127:202-5.  Back to cited text no. 2
    
3.
Sexton J, O’Hare D. Simplified treatment of vascular lesions using the argon laser. J Oral Maxillofac Surg 1993;51:12-16.  Back to cited text no. 3
    
4.
Koslin MG, Martin JC. The use of the holmium laser for temporomandibular joint arthroscopic surgery. J Oral Maxillofac Surg 1993;51:122-3.  Back to cited text no. 4
    
5.
Keller U, Hibst U. Er:YAG laser effects on oral hard and soft tissues. In: Miserendino LJ, Pick RM, editors. Lasers in Dentistry. Chicago, IL: Quintessence; 1995. p. 161-72.  Back to cited text no. 5
    
6.
Moritz A, Gutknecht N, Doertbudak O, Goharkhay K, Schoop U, Schauer P, et al. Bacterial reduction in periodontal pockets through irradiation with a diode laser: A pilot study. J Clin Laser Med Surg 1997;15:33-7.  Back to cited text no. 6
    
7.
Moritz A, Schoop U, Goharkhay K, Schauer P, Doertbudak O, Wernisch J, et al. Treatment of periodontal pockets with a diode laser. Lasers Surg Med 1988;22:302-11.  Back to cited text no. 7
    
8.
Convissar RA. Lasers in general dentistry. Oral Maxillofac Surg Clin North Am 2004;16:165-79.  Back to cited text no. 8
    
9.
Clayman L, Kuo P. Lasers in Maxillofacial Surgery and Dentistry. New York: Thieme; 1997.  Back to cited text no. 9
    
10.
Convissar RA. Principles and Practise of Laser Dentistry. St Louis: Mosby Elsevier; 2010.  Back to cited text no. 10
    
11.
Strauss RA. Lasers in oral and maxillofacial surgery. Dent Clin North Am 2000;44:851-73.  Back to cited text no. 11
    
12.
Müller JG, Berlien P, Scholz C. The medical laser. Med Laser Appl 2006;21:99-108.  Back to cited text no. 12
    


    Figures

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    Tables

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